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Cancer Therapy AdvisorSABR May Be New Standard Care for Primary RCC Not Suitable for Surgery

FASTRACK II Trial Results Indicate Exceptional Cancer Control with Minimal Toxicity

In a recent development, the FASTRACK II trial has revealed that stereotactic ablative body radiotherapy (SABR) offers a highly effective treatment option for patients with primary renal cell carcinoma (RCC) who are not candidates for surgery. The study, presented at the 2023 ASTRO Annual Meeting, has significant implications for the future of kidney cancer treatment.

HCN Medical Memo
Are the FASTRACK II trial results a game-changer? SABR not only offers a viable alternative to surgery but does so with minimal toxicity. This could revolutionize the treatment paradigm for primary RCC, particularly for older patients or those at high risk for surgical complications.

Key Points
  • The FASTRACK II trial focused on the efficacy of SABR in patients with RCC who were medically inoperable or high-risk for surgery.
  • Seventy patients participated, with a median age of 77. The study met its primary endpoint of 1-year local control rate of 90% or better.
  • At a median follow-up of 43 months, both the local control rate and the cancer-specific survival rate were 100%.
  • Dr. Shankar Siva, the study presenter, suggests that SABR should be considered a new standard of care for primary kidney cancer not suited for surgery.

The median age of renal cell carcinoma diagnosis is approximately 64 years, highlighting the need for effective treatments for older populations.

Additional Points
  • Patients experienced a 14.6 mL/min loss in kidney function; one patient required dialysis.
  • Seven patients (10%) experienced grade 3 toxicities, primarily transient pain or nausea/vomiting. No grade 4 or 5 toxicities were reported.

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